Your doctor may secretly think you're making too many office visits and getting too many drugs and tests. A survey of primary-care doctors conducted in 2009 finds that 42% of the 627 respondents believed the patients in their own practice were getting too much care. Just 6% of doctors believed their patients were getting too little care. (The rest thought the level of care was just right.) And 28% of the doctors thought they themselves were practicing more aggressively than they would prefer to. The response rate to the mailed survey was 70%, suggesting this is a topic of interest for doctors — as well as for a health-care system struggling to control costs while helping to improve people's health. The survey, the results of which were published in the latest Archives of Internal Medicine, found 76% of doctors blamed malpractice worries for their over-aggressive care.
A severe shortage of drugs for chemotherapy, infections and other serious ailments is endangering patients and forcing hospitals to buy life-saving medications from secondary suppliers at huge markups because they can't get them any other way. An Associated Press review of industry reports and interviews with nearly two dozen experts found at least 15 deaths in the past 15 months blamed on the shortages, either because the right drug wasn't available or because of dosing errors or other problems in administering or preparing alternative medications. The shortages, mainly involving widely-used generic injected drugs that ordinarily are cheap, have been delaying surgeries and cancer treatments, leaving patients in unnecessary pain and forcing hospitals to give less effective treatments. That's resulted in complications and longer hospital stays
New guidelines for stricter testing of organ donors are raising concerns among transplant surgeons, who fear they may limit availability of organs. The Centers for Disease Control and Prevention issued new guidelines recommending that all organ donors be checked for HIV and hepatitis B and C with the most sensitive screening method, known as nucleic acid testing, the Wall Street Journal reported Thursday. Mitchell Henry, president of the American Society of Transplant Surgeons, and chief of the transplant center at Ohio State University, tells the Health Blog the guidelines go too far in the pursuit of safety, and don't take into consideration the realities of organ transplantation — which is often performed in life-and-death situations with little time to spare.
The family of Edward Harrigan -- a patient who died at Tobey Hospital in Wareham after no one responded to warnings on his cardiac monitor -- filed a federal lawsuit against the hospital and a nurse this week. Harrigan, 87, was a patient at the hospital in September 2008. His electrocardiogram displayed a "flat line" for more than two hours because the battery in his heart monitor had died, but no one changed the battery, according to state Department of Public Health investigators. During that time, his heart stopped. Because the monitor was not working, no alarm sounded to alert staff to his cardiac arrest. They later found him unresponsive and without a pulse. The family's attorney said yesterday that Harrigan's death was caused by alarm fatigue -- when nurses become desensitized to monitor alarms, both audible and visual.
Federal disease investigators have looked into more than 200 cases of unexpected, suspected transmission of HIV, hepatitis B and hepatitis C through transplanted organs between 2007 and 2010, including some cases that led to the recipient's death.
Now, the Centers for Disease Control and Prevention has issued a draft of stricter guidelines of what hospitals and others involved in the transplant process should do to prevent these tragic results. The proposed recommendations were last issued in 1994.
"Our first priority must be patient safety," said Matthew J. Kuehnert, MD, director of the CDC's Office of Blood, Organ and Other Tissue Safety Office. "The guideline will help patients and their doctors have information they need to fully weigh risks and benefits of transplanting a particular organ."
The agency's major draft recommendations include the following:
In addition to screening for HIV, the agency suggests that donors be screened for hepatitis B and hepatitis C viruses.
The agency suggests that labs conducting the testing use more updated and sensitive methods to test organs destined for transplant.
The agency recommends that procurement organizations and others involved in the process use a revised set of donor risk factors that can give clinicians a more thorough picture about possible risks associated with donors' organs.
Since the U.S. Food and Drug Administration has implemented more comprehensive regulations for tissue and semen donors, the agency suggests that centers focus on solid organs and vessel conduits and not other tissues.
The guidelines should apply to organ procurement organizations, transplant centers, clinical coordinators, lab personnel responsible for testing and storing donor and recipient specimens and those responsible for developing and evaluating infection control programs.
"We recognize that organ demand is much greater than availability," Kuehnert said in a statement. "This guideline will assist the transplant community in ensuring that each patient is protected against unexpected diseases from the organ they so desperately need."
A Greene County couple involved in a botched kidney transplant that led to a two-month shutdown of UPMC's living donor kidney and liver transplant programs -- and to state and federal investigations -- filed two malpractice lawsuits this week in Allegheny County Common Pleas Court. Christina Mecannic and Michael Yocabet sued UPMC, University of Pittsburgh Physicians, four doctors and one nurse after federal investigators determined that an entire transplant team missed a test result that showed Mecannic was infected with hepatitis C when her kidney was transplanted into Yocabet on April 6. The 12-count lawsuits allege acts of professional negligence, corporate negligence, intentional and negligent misrepresentation, and intentional and negligent infliction of emotional distress. They ask for compensatory and punitive damages but do not ask for a specific amount. The lawsuits ask for a jury trial.